Ann Cardiothorac Surg.
Posteriorly, there is just one posterior spinal vein, rather than two smaller posterolateral veins, and this is frequently of smaller caliber than the anterior median vein. Greenstein B. A study from Barrey et al.Blood supply of the spinal cord
Revision Received:. Article history.
Discitis after lumbar epidural corticosteroid injection: The incidence an artery was found in Kambin's triangle peaked at the L3 level at 29. MDCT angiography of the spinal vasculature and the artery of Adamkiewicz.
An inexperienced practitioner may not be well-versed in all safety considerations or standard anatomic references of needle placement as recommended by the International Spinal Intervention Society Guidelines [ 45 ]. Although there is a single identifiable artery supplying the spine at the thoracic height, this is not the only source of medullary blood supply.
Other complications of L-TFESI include perineural hematoma [ 18 ], epidural hematoma [ 16 , 17 , 19 ], and infection [ 13—15 , 20 ].
Recently, the safety of the subpedicular approach has been called into question as this route is via the safe triangle. If the patient has known peripheral vascular disease or significant risk factors, further consideration may be given to the use of nonparticulate steroids.
A prospective evaluation of complications of 10,000 fluoroscopically directed epidural injections. It would follow that vascular disease could make patients at higher risk of infarction due to a tenuous blood supply although the data to support this assumption does not exist. Log In. Figure 2.
A subsequent study of CT-angiograms dedicated to the lumbar spine is being planned to obtain this information. Melissano G, Chiesa R.
Cases and figures. Yingbin et al. In the setting of hypoperfusion, the cord can undergo watershed infarction. Thorac Cardiovasc Surg.